How to Improve Teaching About Asthma: The Pivotal Role of the Family Physician in Asthma Education
Teaching about asthma is currently provided by physicians, nurses, respiratory therapists, and other health educators. Therefore, these professionals should possess the basic skills and knowledge to transmit adequately to the patient the concepts that will lead to improvements in self-management. Educators should also be able to assess individual needs and the effectiveness of the education program. However, different reports suggest that the knowledge and skills of nonspecialists are low and should be improved. Improving the efficacy of the education can follow interventions as simple as mailed information, individual training in asthma clinics, or result from specific programs aimed at improving knowledge and education techniques.
Educators must be aware of the current consensus on asthma treatment, management strategies, and particularly on how to teach asthmatics to determine the severity of asthma and modify therapy according to their assessment (Table 1). In the rapidly evolving field of asthma treatment, educators should keep up to date with new therapies, devices, and approaches.
At least two thirds of asthmatics are treated by primary care physicians. Asthma management has changed dramatically in the past 10 years and general practitioners must adapt to several changes. First, asthma treatment now relies on anti-inflammatory drugs rather than on bronchodilators. Sildenafil citrate pink store4family.nl Second, primary care physicians often underestimate the degree of airflow obstruction often failing to measure it objectively. One study showed that general practitioners measure lung function in only 50% of their patients. They were found to instruct their asthmatic patients in how to use peak flowmeters at home in less than 10% of cases. This does not include difficulties in establishing the diagnosis. Considering these facts, it appears that there is a need to educate physicians about how to diagnose asthma and the self-management problems faced by the patient.
Asthma education has gained in popularity in the past 5 years. However, most general practitioners are unaware of the benefits of asthma education, and some family physicians think that self-management plans could even be dangerous for their asthmatic patients. Although most family physicians consider asthma education to be important, it is well known that the time-consuming nature of patient education is often a disincentive to physician involvement in preventive medicine.
Table 1—Training Program for Educators on Asthma
|(1) Professionals involved in asthma education referred by their institutions|
|(2) Initial training session (1 day)|
|• Lectures and discussions on basic knowledge about asthma physiopathology, preventive measures, medication, how to recognize asthma, its etiologies and severity, how to establish control of asthma and maintain it with a minimum of medication, inhaler use, peak flow monitoring, risk factors, and how to treat exacerbations early and effectively with the use of action plans|
|• Pedagogic methods to provide asthmatics and their families with effective self-management skills and relevant knowledge|
|• Small workshops on case reports specifically developed to cover most aspects of asthma education and related problems|
|• Before/after self-assessment questionnaire|
|• Educational materials provided to the educator (demonstrators, plans of action, booklets, etc)|
|(3) One- to 2-week sessions at experienced asthma clinics|
|(4) Regular updates on asthma and its treatment (bulletin, network meetings, and educational activities)|
|(5) Teaching assessment during accreditation visits to their centers|